Chronic Total Occlusion (CTO)

Because CTO blockages harden and calcify over time, only about 2% of interventional cardiologists in the United States have the advanced training necessary to navigate and clear them. Saint Luke’s physicians have perfected a new, minimally invasive technique for opening CTOs in 90% of cases for patients with coronary artery disease. This innovation means less complications and faster recovery times for patients.  

CTO treatment is primarily treated with a highly specialized, minimally invasive procedure called CTO percutaneous coronary intervention (CTO PCI). Our pioneering physicians travel the world teaching other cardiologists this technique. 

Saint Luke’s offers highly successful revascularization CTO PCI techniques including:  

Advanced catheter-based procedures

Interventional cardiologists use a combination of specialized microcatheters and high-torque guidewires to bypass or penetrate the tough, calcified plaque from multiple angles. 

Antegrade approaches

The physician approaches the blockage from the front, moving forward in the natural direction of blood flow.  

Retrograde approaches

If the front of the blockage is completely impenetrable, the physician routes a microcatheter through small blood vessels to reach the blockage from behind. 

Balloon-anchoring techniques

Specialized balloons are inflated in neighboring branch vessels to provide extra stability, allowing the physician to exert more precise force to push through the resistant lesion. 

Our team

Our interventional cardiology team has: 

• Performed more than 2,000 CTO procedures, averaging a 90% success rate—exceeding the 65% national average 
• Decreased average procedural times in half, from 180 to 90 minutes 
• Trained physicians in more than 120 facilities worldwide 
• Served in advisory and leadership roles for the leading interventional cardiology organizations, helping set current and future angioplasty standards and policies 
• Completed some of the seminal research on the benefits and clinical outcomes of CTO angioplasty 

Because our team has performed more CTO angioplasty procedures than any other hospital in the region, Saint Luke’s offers patients the leading-edge expertise and techniques to improve their quality of life, including clinical trials.

Learn more 

Living with chronic total occlusion can rob you of living a fuller life. Learn how angioplasty can restore it with Saint Luke’s  Aaron Grantham, MD, one of the pioneers who developed this lifesaving treatment.